Orthopaedic Regenerative Medicine, LLC
Orthopaedic Surgery, Sports Medicine in Tempe, AZ. Organization (NPI-2).
NPI number1164043204
StatusActive
Last updated in NPPESApr 29, 2020
Details
- NPI
- 1164043204
- Entity type
- Organization (NPI-2)
- Legal business name
- Orthopaedic Regenerative Medicine, LLC
- Organization subpart
- No
- Enumeration date
- Apr 29, 2020
- Certification date
- Apr 29, 2020
- Last updated
- Apr 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207XX0005X | Orthopaedic Surgery, Sports Medicine | – | – | Yes |
Practice location
4765 S Lakeshore DrTempe, AZ 85282-7197
Phone 602-429-0404
Mailing address
4400 N Scottsdale Rd # 9-844Scottsdale, AZ 85251-3331
Authorized official
Angelo Mattalino
Owner
6024290404
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